Seniors who take depression and anxiety drugs shouldn't be prescribed opioid painkillers by their dentist because it puts them at increased risk for problems, researchers warn.
They analyzed 2011-15 dental and medical data for 40,800 patients aged 65 and older across the United States. There were 947 emergency room visits and hospitalizations in the 30 days after a dental visit.
One in 10 of those who were prescribed opioids were also using medications that shouldn't be taken with them. These patients were 23% more likely to visit the ER or require hospitalization within a month of the dental visit where they received the opioid prescription, the study found.
The longer they took the painkillers, the greater their risk. Those whose opioid prescription overlapped with their existing non-compatible medication for more than three days were 47% more likely to require some form of acute medical care.
Even though electronic health records have improved in recent years, dentists often don't have their patients' full medication history, and patients may not remember every medication they're taking, the Oregon State University (OSU)researchers noted.
As a result, dentists may inadvertently prescribe painkillers that shouldn't be taken with other medications, especially those that act on the central nervous system.
"There is this unfortunate opportunity for dentists to prescribe opioids for any acute or chronic pain that the elderly adult is having, and it may actually pose dangerous interactions for those other medications they're on and place them at greater risk of 30-day ER visits and cause hospitalizations," said study co-author Jessina McGregor. She is an epidemiologist and associate professor in the OSU College of Pharmacy in Corvallis.
One challenge is that seniors are more likely to take multiple kinds of medication than younger dental patients, and may also metabolize drugs differently because of age and changes in their kidney function, according to McGregor.
The findings suggest dentists should be better integrated into electronic health systems so they have access to patient records, and that patients need to be more aware of the importance of providing an accurate medication history, researchers said.
The authors added that pharmacists should take a more active role in explaining medications and their possible negative interactions to patients.
The findings were recently published in the journal Pharmacotherapy.
The U.S. National Institute on Drug Abuse has more about prescription opioids.